RED ONE

An ambulance call handler helps a disillusioned
teen in a life-or-death emergency.

The operator usually provides a caller’s name but Edrei doesn’t get one and by the time they are connected the man on the other end of the line is already talking. Fast. Panicked.

‘I said I need an ambulance, yeah… Hello?’

‘I’m here. My name’s Edrei, what’s wrong?’

‘Aren’t you listening? My dad’s fallen or somethink…’ Away from the phone. ‘Dad? Dad?’ Back on the line, ‘He’s dying, ain’t he? Is the ambulance on its way?’

‘I’m finding one. Is your dad breathing?’

‘I don’t know. Can’t you just send a fucking ambulance?’

‘Sir, swearing won’t help.’ Edrei scolds herself for already reprimanding the young man knowing it will only rile him more. On rare occasions, a stern word early on is enough to make a caller reset their attitude. But most are too distraught to be stunned into a better phone manner. And Edrei doesn’t blame them. Still, she needs to get to get this guy focused. And a little rapport wouldn’t go amiss. ‘I need—‘

‘Swearing won’t help what? Fucking jobs worth.’ Irritated and confused. ‘Are you sending an ambulance or not?’

There are others around the control room, others that have been here longer than Edrei that wouldn’t take that kind of abuse. But that wasn’t really abuse by Edrei’s definition. That was desperation. The guy’s father has fallen, potentially in respiratory arrest, and that more often than not indicates cardiac arrest – soon if not already.

Taking the rudeness in her stride, Edrei replies, ‘I’m arranging one…’ It’s not about her. Or the young man. Edrei understands this is about getting an ambulance to the caller’s father: a man who hasn’t sworn or shouted at anyone for all she knows. ‘What’s your name, sir?’

‘Fanish.’

‘Okay, Fanish…’ At her computer, Edrei starts inputting what she can: ‘I need to know a few things so we can give the crew the right information…’ She poises herself. ‘Okay?’

The line crackles with heavy breaths. ‘I’m here…’ voice wavering. Edrei guesses Fanish is in his late teens or early twenties. Fearing for their father’s life, the young man stammers a little and holds back sobs. ‘Love, h-he’s on the floor. He ain’t moving. I’ve tried waking him up, but he ain’t saying nothing.’

‘Alright,’ Edrei punches at the keyboard, listening, typing and sending on anything that will help. ‘Sir, an ambulance is on its way. It’ll be a few minutes but there are things we can do to help your dad in the meantime.’

‘Like what?’

‘Is your father breathing? If you can go over to him—‘

‘I’m right next to him. I ain’t gone for a bloody walk, have I?’

‘Sir, I need you to be calm.’

‘My dad’s dying here. I ain’t getting calmer.’

‘Okay, so you’re kneeling beside him.’ Edrei sits forward at her. It still frustrates her whenever becoming the recipient of anger from the people she’s trying to help, but it doesn’t hurt as much as it used to. That’s part of the reason she’s no longer a paramedic. Edrei got a buzz riding around town, literally saving lives on a weekly basis (at least weekly). But each time she gets nostalgic, Edrei soon remembers how glad she is now to be shot of the physical abuse that sometimes came with the job. Not the self-inflicted abuse of regular fourteen-hour shifts, turning nocturnal, then switching back but never recovering the lost sleep, racing up flights of stairs, elevators always being out of service, lifting heavy equipment, and lifting heavy people. None of that hurt too much. It was the being spat at, pushed, hit, bitten, and nearly stabbed she hadn’t signed up for. That’s what hurt. Physically, obviously. And in other ways. At one point, it felt like that was weekly. That was too much. This verbal abuse she can stomach. And this guy isn’t too bad. Just understandably distressed. Most regular people are unprepared for this – they might come across this kind of thing once in their life, if their unlucky. It’s this young man’s unlucky day. But almost thirty of these calls come in from around London each day, so Edrei and her colleagues each get their fair share. Ready, with her fingers hovering over the keyboard, ‘Sir, is he lying flat on the floor?’

‘Yeah.’

‘Can you lean over him and listen if he’s breathing?’

‘Okay…’

‘Even faint breaths…’ Edrei waits a moment. ‘Is he breathing?’ Edrei adjusts her headset. It itches the top of her left ear. ‘Sir? Is he—‘

Sobs. ‘He’s fucking dead… He ain’t breathing. He’s deaaad, man… m-my…’

‘Hold on, sir. He might not be breathing but that doesn’t mean…’ Rapidly punching keys, Edrei updates the dispatch information. ‘It doesn’t mean we should stop.’ In seconds the crew en route to the flat near Heathbrook Park know they have a cardiac arrest, a Red One. Before this, there was a chance that the ambulance headed to the flat could be diverted to a more urgent emergency. Now there was no risk of another call taking higher priority. ‘Are you still next to him?’ A couple of seconds pass. Crew E2-6 are four minutes away. At this time on a Wednesday night, they shouldn’t hit any real traffic, their blue lights and siren keeping most drivers out of the way. Racing up Lansdowne Way and then down Wandsworth Road, they might only be slowed by a few hungry folk turning into the Maccies drive-thru. Edrei tries again, ‘Are you still kneeling down? I need you to—‘

‘Love, I’m hanging up…’

‘No, wait!’

‘Or will the ambulance take him to—‘

‘Sir, we need to get him breathing again. I need you to begin compressions.’

‘What?

‘CPR. We need to get him breathing. Every second counts.’

‘What do I do?’

‘Kneel beside your father and…’ within a few moments Fanish is starting compressions on the other end of the line. His dad Albert Pratt is fifty-eight. White. Younger than average for a heart attack debut but has no history of heart disease, no diabetes, and no strokes. A few eye problems, but he manages those. And he smokes occasionally. Apparently, he’s had hyperthyroidism for as long as Fanish can remember. At one point, Fanish admits confusing that previously with hypothyroidism. ‘Tapazole?’ he recognises the name of his father’s medication. Hyper. Not hypo.

‘Thirteen. Fourteen…’ Breathy numbers as Fanish counts with each push.

‘Is anyone else with you there?’ Edrei doesn’t want to distract Fanish now he’s calmer, but more help could be useful. Fanish explains that it’s just him and Albert. He goes on that his name was chosen by his mother. She was Indian. He loses count, but Edrei is keeping track. Counting between Fanish’s short sentences. ‘Twenty-four. Twenty-five…’

‘Twenty-six.’ Fanish resumes counting. Only four to go. A rapport is building and hope with it. Edrei thinks of her own father. He passed five years ago. Too young. Guessing that Fanish is at least a her junior, Edrei feels bad that he might soon find himself without parents despite his young age.

‘You’re doing great, Fanish…’ She waits while he delivers two rescue breaths. ‘Do you hear anything?’

‘I don’t know… I…’

‘Let’s keep going… thirty more… you’re doing amazing and—‘

‘No, I ain’t. He’s fucking dying… why are you making me do this?’

‘One. Two. And three. One. Two. And three…’ Edrei hears Fanish puff as he restarts compressions. She estimates Albert might not have been breathing for about ninety seconds before Fanish started CPR. She knows the chances of Albert making it through this are slim. Back from the brink is possible: Edrei reckons a twenty per cent chance of Albert’s heart starting beating again. The ROSC (return of spontaneous circulation) could get Albert to the hospital, but the next few hours would be critical and so few people make it through another ten days. Edrei keeps counting, and coaching Fanish over the phone. Only two and a half miles from Edrei’s desk near Waterloo to Fanish’s living room and yet vast gulfs between them.

In the years Edrei’s been on the job, odds have improved incrementally. But not nearly as much as they could. A lot of the time, no one tries CPR. Even bystanders who have done first aid courses freeze up or their minds go blank, or they just assume the worst before trying. Even novice compressions keep a lot of patients in the game. Especially when there’s hope. Edrei doesn’t want to give the guy false hope but pragmatism, stats, and preparing for the worst don’t help anyone in these situations. It doesn’t help the person trying and, if they begin to falter under the weight of discouraging averages, it doesn’t help the person they are trying for.

‘This is knackering,’ Fanish half-jokes between pushes.

‘Not for a young lad like you,’ Edrei steers clear of how the CPR could be all that stands between life and death for Fanish’s dad. Fanish is engaged and that’s what they all need. Not only engaged, but increasingly hopeful, surprised and possibly empowered by the thought that he can turn things around. ‘I’ve never made anyone proud.’

‘I’m sure that’s not true,’ Edrei says kindly.

‘Things always go sideways or somethink,’ Fanish says between compressions. ‘But not today…’

Edrei worries the compressions are not being delivered quickly enough and encourages Fanish to focus more.

Speeding up, with shorter sentences, Fanish finishes what he was saying. ‘Like… If we can get him through this… I’ll go back college… or…’ Edrei counts as Fanish describes getting a girlfriend or something that would make his dad proud of him.

Edrei assures Fanish his dad is probably already very proud, and counts thirty. ‘Okay, try breathing through his mouth again. Once… and twice… anything?’

Seconds feel like hours as Edrei waits for a reply. She gets a notification on her screen that a second unit has been dispatched to Albert’s emergency. An advanced paramedic who specialises in cardiac arrests and rides a car solo from one incident to the next, providing ambulance teams with other support where needed. Not so long ago, in her own days as a paramedic, Edrei knew an AP who went to nearly one hundred and fifty cardiac arrest patients in a year. With only one in five of those making it to the hospital, it took a toll on the guy. Stan was his name. Edrei often wonders if she would have lasted longer on the front line had she been given more psychological support and felt less pressure to stretch herself across so many hours.

Having delivered two breaths, Fanish resumes compressions. Faster. Steadier. Less chat now.

The AP should reach the flat within two minutes of the ambulance. Edrei lets Fanish know but he doesn’t seem very encouraged. His empowered hope seems to be waning. ‘I’ve seen it lots… on different shows… are you sure it does usually just take two or three rounds?’

‘It’s not like on TV,’ Edrei replies. ‘You just need to keep going.’ Edrei explains that it takes a medical professional to know when to stop.

On the fourth round of compressions, Fanish seems to be regaining hope from somewhere. Despite what he’s seen on TV. He’s talking to his dad as he pushes. Inaudible down the line. Too mumbled for Edrei to make out. But there lots of hope. Maybe some of Fanish’s hope feeds back to Edrei and she imagines it all somehow giving Albert a lift. But then…

‘No, it ain’t working…’

‘It could be. Your dad just needs you to keep going. Can you do that?

‘Where’s the ambulance, man?’

Not bothering to question why he keeps calling her ‘man’ and not wanting him to revert back to ‘love’, Edrei remains focused, ‘Fanish, have you started compressions again. We need you to—’

‘I’m doing it,’ Fanish catches his breath, ‘I can’t always count and talk at the same time, yeah! Where’s the ambulance?’

‘The ambulance is literally down the street.’ Edrei checks her screen and reminds Fanish of the second unit. ‘They’ll be a minute tops. You should be able to hear them any second now.’ She waits a while. Edrei can’t hear Fanish puffing or counting anymore. Mobile reception always drops out at the wrong time. But Edrei doesn’t see what would have changed. ‘Fanish, I think I lost you for a mo. Are you still there?’ Silence. Nothing comes back but a few crackles, the noise of emptiness filling the line. ‘Fanish, we’ll be coming up to thirty.’

‘I’ve stopped…’

‘You’re already breathing into his mouth again?’

‘Somethink happened. I think I’ve killed him…’ Overwhelmed. All hope lost. ‘I pushed too hard and felt like -his -his chest has… I’ve—’

‘You might have broken his sternum but don’t worry.’

‘Huh?’

‘His breastbone. The sternum. Don’t stop CPR, Fanish. You need to keep going. Yeah?’

‘Okay -okay -I’m doing it…’

‘Good man…’ Checks her console. ‘You should be able to hear the ambulance.’

‘Yeah, I can but I… I… they’ve still got to get up here…’

‘Don’t worry, I’ve told them you’re on the third floor. And I’m not going anywhere until they’re with you. Okay?’

‘Yeah.’

Edrei counts for Fanish and encourages him to go faster. She wants a hundred compressions a minute or more. Not one a second. Fanish picks up the pace. He’s delivering the second breath when knocking comes at the door. ‘Go answer the door,’ Edrei instructs and waits. A bassy ruffle as Fanish picks the phone up from the floor, takes it with him to the door, lets in the crew. A paramedic and an EMT. Edrei is surprised by how clearly Fanish tells the crew what he’s been doing. A male’s voice in the background mentions a defibrillator. And another speaks of adrenaline. Then comes more noise and muffled voices. Distant. Edrei hangs on the line. ‘How’s it going Fanish? Hello…’

‘Edrei. They’re here…’

‘Ace. I’ll leave you in their capable hands, okay?’

‘Yeah… wait though…’

‘Fanish?’

‘Thanks, yeah.’

‘You did really well… I know for a fact, you’ve already done your dad proud.’

More crackling and a heavy breath. ‘I’ve gotta go, yeah… bye.’

Before Edrei can reply, there’s a beep as Fanish hangs up. Five minutes she imagines he won’t ever forget. Five minutes that might have made all the difference. She lives in hope, against the stats. Edrei breathes out. And in. Not knowing what will happen to Albert. Nor Fanish. But grateful for the young man’s appreciation in the end. And for him trying in the first place.